宁波市江北区2012—2014年手足口病重复发病率及其影响因素
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摘要
目的了解宁波市江北区2012—2014年手足口病重复发病率、重复发病发生率,分析其影响因素,为手足口病防控工作提供科学依据。方法 2012—2014年江北区手足口病数据来自中国疾病监测信息系统,接种资料来自宁波市免疫规划信息系统,筛选多次感染的病例,采用描述流行病学的方法进行分析。结果宁波市江北区2012—2014年重复发病发生率为5.40%,手足口病患者发病月龄中位数单次发病为33.77(20.03,47.83)月,重复发病为38.26(22.05,54.75)月,第一次发病为23.93(15.87,36.87)月;重复发病的时间间隔中位数为10.27(5.23,16.06)月。3~岁组的重复发病发生率最高(χ2=37.51,P<0.001)。职业分布主要以散居儿童和幼托儿童为主。性别为女性是手足口病重复发病的保护因素(OR=0.73,95%CI:0.57~0.92),职业为幼托儿童是手足口病重复发病的危险因素(OR=1.46,95%CI:1.16~1.84)。重复发病病例所在街道7 d内罹患率中位数为10.36(9.29,11.44)/10万,对照组街道同期罹患率中位数为8.95(8.16,9.74)/10万,两者间比较,差异有统计学意义(Z=-2.68,P<0.001)。重复发病儿童(病例组)与对照组接种针次比较,差异无统计学意义(Z=-1.38,P=0.17)。结论宁波市江北区2012—2014年手足口病重复发病疫情较严重,应重点关注男童、幼托儿童等人群,减少其与患者接触,采取针对性防控措施。
Objective To investigate the incidence of recurrence and occurrence rate of recurrence of hand-footand-mouth disease(HFMD)in Jiangbei District of Ningbo City between2012 and 2014,analyze the influencing factors,and provide a scientific basis for the prevention and control of HFMD.Methods Data of HFMD in Jiangbei in2012-2014 were collected from China Disease Surveillance Information System,immunization data were from Immunization Programme Information System of Ningbo City,the recurrent infectious cases were selected and analyzed by descriptive epidemiological methods.Results The occurrence rate of recurrent HFMD in Jiangbei in 2012-2014 was 5.40%,the median month of patients with single occurrence and recurrence of HFMD were 33.77(20.03,47.83)and 38.26(22.05,54.75)months respectively,median month of patients with the initial occurrence were23.93(15.87,36.87)months,median of time interval of recurrent HFMD was 10.27(5.23,16.06)months.The occurrence rate of recurrence was the highest in3-years old group(χ2=37.51,P<0.001).Most were scattered children and children in child-care center.Female was a protective factor of recurrence of HFMD(OR,0.73[95%CI,0.57-0.92]),while children in child-care center was a risk factor(OR,1.46[95%CI,1.16-1.84]).The median attack rate of recurrence in HFMD group and control group in blocks within 7 days were 10.36(9.29,11.44)/100 000 and 8.95(8.16,9.74)/100 000 respectively,there was significant difference(Z=-2.68,P<0.001).Inoculation frequency between recurrent HFMD group and control group was not significantly different(Z=-1.38,P=0.17).Conclusion The epidemic of recurrence of HFMD was serious in Jiangbei District of Ningbo City between2012 and 2014,boys and children in child-care center should be paid attention,contacts with patients should be reduced,and targeted prevention and control measures should be carried out.
Objective To investigate the incidence of recurrence and occurrence rate of recurrence of hand-footand-mouth disease(HFMD)in Jiangbei District of Ningbo City between2012 and 2014,analyze the influencing factors,and provide a scientific basis for the prevention and control of HFMD.Methods Data of HFMD in Jiangbei in2012-2014 were collected from China Disease Surveillance Information System,immunization data were from Immunization Programme Information System of Ningbo City,the recurrent infectious cases were selected and analyzed by descriptive epidemiological methods.Results The occurrence rate of recurrent HFMD in Jiangbei in 2012-2014 was 5.40%,the median month of patients with single occurrence and recurrence of HFMD were 33.77(20.03,47.83)and 38.26(22.05,54.75)months respectively,median month of patients with the initial occurrence were23.93(15.87,36.87)months,median of time interval of recurrent HFMD was 10.27(5.23,16.06)months.The occurrence rate of recurrence was the highest in3-years old group(χ2=37.51,P<0.001).Most were scattered children and children in child-care center.Female was a protective factor of recurrence of HFMD(OR,0.73[95%CI,0.57-0.92]),while children in child-care center was a risk factor(OR,1.46[95%CI,1.16-1.84]).The median attack rate of recurrence in HFMD group and control group in blocks within 7 days were 10.36(9.29,11.44)/100 000 and 8.95(8.16,9.74)/100 000 respectively,there was significant difference(Z=-2.68,P<0.001).Inoculation frequency between recurrent HFMD group and control group was not significantly different(Z=-1.38,P=0.17).Conclusion The epidemic of recurrence of HFMD was serious in Jiangbei District of Ningbo City between2012 and 2014,boys and children in child-care center should be paid attention,contacts with patients should be reduced,and targeted prevention and control measures should be carried out.
引文
[1]吴晓华,陶兴永.手足口病的三级预防策略[J].中华疾病控制杂志,2010,14(2):162-165.
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[4]胡青坡,孙乔,何纳,等.上海市浦东新区手足口病单次与重复感染病例流行病学特征分析[J].中华疾病控制杂志,2014,18(4):363-365.
[5]王铁强,帅惠萍,邓爱萍,等.2009~2011年某省手足口病重复发病人群的特征分析[J].中国医药指南,2013,11(13):38-39.
[6]谢忠杭,王灵岚,严延生,等.福建省4岁以下儿童手足口病再次罹患特征的队列分析[J].中华流行病学杂志,2014,35(10):1109-1114.
[7]黄晓玉,危国强,兰文林,等.南宁市武鸣县1 268名手足口病多次感染病例流行病学分析[J].职业与健康,2013,29(19):2512-2514.
[8]Huang Y,Zhou Y,Lu H,et al.Characterization of severe hand,foot,and mouth disease in Shenzhen,China,2009-2013[J].J Med Virol,2015,87(9):1471-1479.
[9]别芹芹,邱冬生,胡辉,等.我国手足口病时空分布特征的GIS分析[J].地球信息科学学报,2010,12(3):380-384.
[10]贺天锋,杨天池,易波,等.宁波市2011年手足口病经济负担估计[J].上海预防医学,2012,24(9):476-478.
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[12]谢清梅,李宗瑾,李艳艳,等.2008-2010年平顶山市手足口病重复感染情况的调查[J].中华疾病控制杂志,2012,16(4):315-317.
[13]朱渭萍,薛曹怡,沈迪莘,等.上海市浦东新区手足口病流行病学调查及影响因素分析[J].中国妇幼保健,2010,25(17):2401-2403.
[14]王晨,朱渭萍,孙晓冬,等.手足口病多次就诊及多次感染影响因素分析[J].安徽预防医学杂志,2012,18(1):27-30,57.
[15]Chen GP,Wu JB,Wang JJ,et al.Epidemiological characteristics and influential factors of hand,foot and mouth disease(HFMD)reinfection in children in Anhui province[J].Epidemiol Infect,2016,144(1):153-160.
[16]Li Y,Zhang J,Zhang X.Modeling and preventive measures of hand,foot and mouth disease(HFMD)in China[J].Int J Environ Res Public Health,2014,11(3):3108-3117.
[17]Xie YH,Chongsuvivatwong V,Tan Y,et al.Important roles of public playgrounds in the transmission of hand,foot,and mouth disease[J].Epidemiol Infect,2015,143(7):1432-1441.
[18]Tian H,Zhang Y,Sun Q,et al.Prevalence of multiple enteroviruses associated with hand,foot,and mouth disease in Shijiazhuang City,Hebei province,China:outbreaks of coxsackieviruses a10 and b3[J].PLoS One,2014,9(1):e84233.
[19]Herrero LJ,Lee CS,Hurrelbrink RJ,et al.Molecular epidemiology of enterovirus71 in peninsular Malaysia,1997-2000[J].Arch Virol,2003,148(7):1369-1385.
[20]Ooi MH,Wong SC,Clear D,et al.Adenovirus type 21-associatedacute flaccid paralysis during an outbreak of hand-footand-mouth disease in Sarawak,Malaysia[J].Clin Infect Dis,2003,36(5):550-559.
[2]中华人民共和国卫生部.手足口病预防控制指南[S].北京,2009.
[3]闫磊,黄晓霞,王晓芳,等.手足口病多次感染的地理流行病学研究[J].中国预防医学杂志,2010,11(6):548-550.
[4]胡青坡,孙乔,何纳,等.上海市浦东新区手足口病单次与重复感染病例流行病学特征分析[J].中华疾病控制杂志,2014,18(4):363-365.
[5]王铁强,帅惠萍,邓爱萍,等.2009~2011年某省手足口病重复发病人群的特征分析[J].中国医药指南,2013,11(13):38-39.
[6]谢忠杭,王灵岚,严延生,等.福建省4岁以下儿童手足口病再次罹患特征的队列分析[J].中华流行病学杂志,2014,35(10):1109-1114.
[7]黄晓玉,危国强,兰文林,等.南宁市武鸣县1 268名手足口病多次感染病例流行病学分析[J].职业与健康,2013,29(19):2512-2514.
[8]Huang Y,Zhou Y,Lu H,et al.Characterization of severe hand,foot,and mouth disease in Shenzhen,China,2009-2013[J].J Med Virol,2015,87(9):1471-1479.
[9]别芹芹,邱冬生,胡辉,等.我国手足口病时空分布特征的GIS分析[J].地球信息科学学报,2010,12(3):380-384.
[10]贺天锋,杨天池,易波,等.宁波市2011年手足口病经济负担估计[J].上海预防医学,2012,24(9):476-478.
[11]查兵,詹圣伟,曹多志,等.马鞍山市手足口病重复感染病例流行病学调查[J].职业与健康,2013,29(14):1769-1770,1773.
[12]谢清梅,李宗瑾,李艳艳,等.2008-2010年平顶山市手足口病重复感染情况的调查[J].中华疾病控制杂志,2012,16(4):315-317.
[13]朱渭萍,薛曹怡,沈迪莘,等.上海市浦东新区手足口病流行病学调查及影响因素分析[J].中国妇幼保健,2010,25(17):2401-2403.
[14]王晨,朱渭萍,孙晓冬,等.手足口病多次就诊及多次感染影响因素分析[J].安徽预防医学杂志,2012,18(1):27-30,57.
[15]Chen GP,Wu JB,Wang JJ,et al.Epidemiological characteristics and influential factors of hand,foot and mouth disease(HFMD)reinfection in children in Anhui province[J].Epidemiol Infect,2016,144(1):153-160.
[16]Li Y,Zhang J,Zhang X.Modeling and preventive measures of hand,foot and mouth disease(HFMD)in China[J].Int J Environ Res Public Health,2014,11(3):3108-3117.
[17]Xie YH,Chongsuvivatwong V,Tan Y,et al.Important roles of public playgrounds in the transmission of hand,foot,and mouth disease[J].Epidemiol Infect,2015,143(7):1432-1441.
[18]Tian H,Zhang Y,Sun Q,et al.Prevalence of multiple enteroviruses associated with hand,foot,and mouth disease in Shijiazhuang City,Hebei province,China:outbreaks of coxsackieviruses a10 and b3[J].PLoS One,2014,9(1):e84233.
[19]Herrero LJ,Lee CS,Hurrelbrink RJ,et al.Molecular epidemiology of enterovirus71 in peninsular Malaysia,1997-2000[J].Arch Virol,2003,148(7):1369-1385.
[20]Ooi MH,Wong SC,Clear D,et al.Adenovirus type 21-associatedacute flaccid paralysis during an outbreak of hand-footand-mouth disease in Sarawak,Malaysia[J].Clin Infect Dis,2003,36(5):550-559.